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目的探讨IL-2、IL-18与TNF-α在流行性乙型脑炎(乙脑)发病中的作用及其与预后的关系。方法 90例乙脑患儿分别于急性期和恢复期留取血清及脑脊液,-70℃冻存;以酶免疫法检测IL-2、IL-18、TNF-α水平。结果急性期血清脑脊液中IL-2、IL-18、TNF-α水平均升高,而恢复期降低;急性期脑脊液中IL-2、IL-18和TNF-α水平较同期血清中的高。TNF-α的水平与疾病轻重程度呈正相关,IL-18水平持续升高常提示预后不良。IL-2与TNF-α的水平呈正相关,IL-2与预后之间关系不明显。结论流行性乙型脑炎患儿血清及脑脊液TNF-α、IL-2和IL-18水平的升高与流行性乙型脑炎严重程度及预后有关,测定这些细胞因子水平对流行性乙型脑炎判断病情及预后具有指导意义。
Objective To investigate the role of IL-2, IL-18 and TNF-α in the pathogenesis of Japanese encephalitis (JE) and its relationship with prognosis. Methods Serum and cerebrospinal fluid (CSF) were collected from 90 children with encephalitis B at acute and convalescent stage, and frozen at -70 ℃. The levels of IL-2, IL-18 and TNF-α were detected by enzyme immunoassay. Results The level of IL-2, IL-18 and TNF-α in serum and cerebrospinal fluid of patients in acute phase increased, while the recovery period decreased. The levels of IL-2, IL-18 and TNF-α in cerebrospinal fluid in acute phase were higher than those in the same period. TNF-α levels and severity of the disease was positively correlated, IL-18 levels often indicate the poor prognosis. IL-2 and TNF-α levels were positively correlated, IL-2 and prognosis of the relationship was not obvious. Conclusions Elevated levels of TNF-α, IL-2 and IL-18 in serum and cerebrospinal fluid of children with Japanese encephalitis are related to the severity and prognosis of Japanese encephalitis. The levels of these cytokines in patients with epidemic type B Encephalitis to determine the condition and prognosis of the guidance.